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伊朗患者肝移植后新发糖尿病中血管紧张素原M235T和T174M多态性、人口统计学及临床因素的评估

Evaluation of Angiotensinogen M235T and T174M Polymorphisms, Demographic and Clinical Factors in New-Onset Diabetes after Liver Transplantation in Iranian Patients.

作者信息

Mottaghi S, Azarpira N, Dehshahri A, Khalvati B, Namazi S

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.

Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Organ Transplant Med. 2019;10(3):137-147.

Abstract

BACKGROUND

New-onset diabetes after transplantation (NODAT) is a serious complication which runs the risk of infections, morbidity and mortality.

OBJECTIVE

To evaluate M235T and T174M polymorphisms of angiotensinogen gene along with some demographic and clinical factors including age; sex; body mass index (BMI); model for end-stage liver disease (MELD) score; prednisolone, mycophenolate mofetil and tacrolimus dose; and serum level in NODAT among liver recipients.

METHODS

In this study 115 patients (53 with and 62 without NODAT) who had no history of diabetes before the transplantation were investigated. Furthermore, 80 randomly selected apparently healthy people (no transplantation) were used as the control group. Two angiotensinogen polymorphisms (M235T and T174M) were studied using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP).

RESULTS

Patients included 68 (59.1%) females and 47 (40.9%) males; they had a mean±SD age of 37.4±16.9 years. The M allele frequency was 55.7% (n=128) in M235T and 20.0% (n=46) in T174M polymorphisms. Binary logistic regression analysis confirmed that age (p=0.005), prednisolone dose (p<0.001) and mutated M235T polymorphism (p=0.003) were independent risk factors.

CONCLUSION

Presence of M235T T allele may significantly (p<0.001) increase the NODAT risk, and increase the likelihood of developing end-stage liver disease (p=0.003). T174M T allele had a significantly (p=0.007) higher frequency in NODAT group.

摘要

背景

移植后新发糖尿病(NODAT)是一种严重并发症,存在感染、发病和死亡风险。

目的

评估血管紧张素原基因的M235T和T174M多态性,以及一些人口统计学和临床因素,包括年龄、性别、体重指数(BMI)、终末期肝病模型(MELD)评分、泼尼松龙、霉酚酸酯和他克莫司剂量,以及肝移植受者中NODAT的血清水平。

方法

本研究调查了115例移植前无糖尿病史的患者(53例患有NODAT,62例未患NODAT)。此外,随机选择80名明显健康的人(未进行移植)作为对照组。使用聚合酶链反应限制性片段长度多态性(PCR-RFLP)研究两种血管紧张素原多态性(M235T和T174M)。

结果

患者包括68名(59.1%)女性和47名(40.9%)男性;他们的平均年龄±标准差为37.4±16.9岁。M235T中M等位基因频率为55.7%(n = 128),T174M多态性中为20.0%(n = 46)。二元逻辑回归分析证实,年龄(p = 0.005)、泼尼松龙剂量(p < 0.001)和突变的M235T多态性(p = 0.003)是独立危险因素。

结论

M235T的T等位基因的存在可能显著(p < 0.001)增加NODAT风险,并增加发生终末期肝病的可能性(p = 0.003)。T174M的T等位基因在NODAT组中的频率显著更高(p = 0.007)。

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